Journal of Pediatrics Review

Published by: Kowsar

Necrotizing Enterocolitis: A Narrative Review of Updated Therapeutic and Preventive Interventions

Brittany Michelle Reid 1 , * and Alecia Thompson-Branch 1
Authors Information
1 Division of Neonatology, The Children’s Hospital at Montefiore, Bronx, USA
Article information
  • Journal of Pediatrics Review: July 2016, 4 (2); e6093
  • Published Online: June 25, 2016
  • Article Type: Review Article
  • Received: March 18, 2016
  • Revised: June 4, 2016
  • Accepted: June 11, 2016
  • DOI: 10.17795/jpr-6093

To Cite: Reid B M, Thompson-Branch A. Necrotizing Enterocolitis: A Narrative Review of Updated Therapeutic and Preventive Interventions, J Pediatr Rev. 2016 ;4(2):e6093. doi: 10.17795/jpr-6093.

Copyright © 2016, Mazandaran University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Context
2. Evidence Acquisition
3. Results
4. Conclusions
  • 1. Sharma R, Hudak ML. A clinical perspective of necrotizing enterocolitis: past, present, and future. Clin Perinatol. 2013; 40(1): 27-51[DOI][PubMed]
  • 2. Neu J. Necrotizing enterocolitis: the mystery goes on. Neonatology. 2014; 106(4): 289-95[DOI][PubMed]
  • 3. Gephart SM, McGrath JM, Effken JA, Halpern MD. Necrotizing enterocolitis risk: state of the science. Adv Neonatal Care. 2012; 12(2): 77-87[DOI][PubMed]
  • 4. Chen AC, Chung MY, Chang JH, Lin HC. Pathogenesis implication for necrotizing enterocolitis prevention in preterm very-low-birth-weight infants. J Pediatr Gastroenterol Nutr. 2014; 58(1): 7-11[DOI][PubMed]
  • 5. Claud EC, Walker WA. Hypothesis: inappropriate colonization of the premature intestine can cause neonatal necrotizing enterocolitis. FASEB J. 2001; 15(8): 1398-403[PubMed]
  • 6. Claud EC. Neonatal Necrotizing Enterocolitis -Inflammation and Intestinal Immaturity. Antiinflamm Antiallergy Agents Med Chem. 2009; 8(3): 248-59[DOI][PubMed]
  • 7. Tanner SM, Berryhill TF, Ellenburg JL, Jilling T, Cleveland DS, Lorenz RG, et al. Pathogenesis of necrotizing enterocolitis: modeling the innate immune response. Am J Pathol. 2015; 185(1): 4-16[DOI][PubMed]
  • 8. Amin SC, Remon JI, Subbarao GC, Maheshwari A. Association between red cell transfusions and necrotizing enterocolitis. J Matern Fetal Neonatal Med. 2012; 25: 85-9[DOI][PubMed]
  • 9. Gephart SM. Transfusion-associated necrotizing enterocolitis: evidence and uncertainty. Adv Neonatal Care. 2012; 12(4): 232-6[DOI][PubMed]
  • 10. Afrazi A, Sodhi CP, Good M, Jia H, Siggers R, Yazji I, et al. Intracellular heat shock protein-70 negatively regulates TLR4 signaling in the newborn intestinal epithelium. J Immunol. 2012; 188(9): 4543-57[DOI][PubMed]
  • 11. Gritz EC, Bhandari V. The human neonatal gut microbiome: a brief review. Front Pediatr. 2015; 3: 17[DOI][PubMed]
  • 12. Clark RH, Gordon P, Walker WM, Laughon M, Smith PB, Spitzer AR. Characteristics of patients who die of necrotizing enterocolitis. J Perinatol. 2012; 32(3): 199-204[DOI][PubMed]
  • 13. La Rosa PS, Warner BB, Zhou Y, Weinstock GM, Sodergren E, Hall-Moore CM, et al. Patterned progression of bacterial populations in the premature infant gut. Proc Natl Acad Sci U S A. 2014; 111(34): 12522-7[DOI][PubMed]
  • 14. Stone ML, Tatum PM, Weitkamp JH, Mukherjee AB, Attridge J, McGahren ED, et al. Abnormal heart rate characteristics before clinical diagnosis of necrotizing enterocolitis. J Perinatol. 2013; 33(11): 847-50[DOI][PubMed]
  • 15. Epelman M, Daneman A, Navarro OM, Morag I, Moore AM, Kim JH, et al. Necrotizing enterocolitis: review of state-of-the-art imaging findings with pathologic correlation. Radiographics. 2007; 27(2): 285-305[DOI][PubMed]
  • 16. Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, Barton L, et al. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann Surg. 1978; 187(1): 1-7[PubMed]
  • 17. Dimmitt RA, Moss RL. Clinical management of necrotizing enterocolitis. NeoReviews. 2001; 2(5): 110-7[DOI]
  • 18. Autmizguine J, Hornik CP, Benjamin DJ, Laughon MM, Clark RH, Cotten CM, et al. Anaerobic antimicrobial therapy after necrotizing enterocolitis in VLBW infants. Pediatrics. 2015; 135(1): 117-25[DOI][PubMed]
  • 19. Zani A, Pierro A. Necrotizing enterocolitis: controversies and challenges. F1000Res. 2015; 4[DOI][PubMed]
  • 20. Henderson G, Anthony MY, McGuire W. Formula milk versus maternal breast milk for feeding preterm or low birth weight infants. Cochrane Database Syst Rev. 2007; (4): 2972[DOI][PubMed]
  • 21. Boyd CA, Quigley MA, Brocklehurst P. Donor breast milk versus infant formula for preterm infants: systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed. 2007; 92(3)-75[DOI][PubMed]
  • 22. Sisk PM, Lovelady CA, Dillard RG, Gruber KJ, O'Shea TM. Early human milk feeding is associated with a lower risk of necrotizing enterocolitis in very low birth weight infants. J Perinatol. 2007; 27(7): 428-33[DOI][PubMed]
  • 23. Berseth CL, Bisquera JA, Paje VU. Prolonging small feeding volumes early in life decreases the incidence of necrotizing enterocolitis in very low birth weight infants. Pediatrics. 2003; 111(3): 529-34[PubMed]
  • 24. Morgan J, Bombell S, McGuire W. Early trophic feeding versus enteral fasting for very preterm or very low birth weight infants. Cochrane Database Syst Rev. 2013; (3): 504[DOI][PubMed]
  • 25. Maas C, Mitt S, Full A, Arand J, Bernhard W, Poets CF, et al. A historic cohort study on accelerated advancement of enteral feeding volumes in very premature infants. Neonatology. 2013; 103(1): 67-73[DOI][PubMed]
  • 26. Morgan J, Young L, McGuire W. Slow advancement of enteral feed volumes to prevent necrotising enterocolitis in very low birth weight infants. Cochrane Database Syst Rev. 2011; (3): 1241[DOI][PubMed]
  • 27. Thoene M, Hanson C, Lyden E, Dugick L, Ruybal L, Anderson-Berry A. Comparison of the effect of two human milk fortifiers on clinical outcomes in premature infants. Nutrients. 2014; 6(1): 261-75[DOI][PubMed]
  • 28. Knol J, Boehm G, Lidestri M, Negretti F, Jelinek J, Agosti M, et al. Increase of faecal bifidobacteria due to dietary oligosaccharides induces a reduction of clinically relevant pathogen germs in the faeces of formula-fed preterm infants. Acta Paediatr Suppl. 2005; 94(449): 31-3[DOI][PubMed]
  • 29. Deshpande G, Rao S, Patole S. Probiotics for prevention of necrotising enterocolitis in preterm neonates with very low birthweight: a systematic review of randomised controlled trials. Lancet. 2007; 369(9573): 1614-20[DOI][PubMed]
  • 30. Hoyos AB. Reduced incidence of necrotizing enterocolitis associated with enteral administration of lactobacillus acidophilus and bifidobacterium infantis to neonates in an intensive care unit. J Infect Dis. 1999; 3(4): 197-202[DOI]
  • 31. Lin HY, Chang JH, Chung MY, Lin HC. Prevention of necrotizing enterocolitis in preterm very low birth weight infants: is it feasible? J Formos Med Assoc. 2014; 113(8): 490-7[DOI][PubMed]
  • 32. Lin HC, Su BH, Chen AC, Lin TW, Tsai CH, Yeh TF, et al. Oral probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight infants. Pediatrics. 2005; 115(1): 1-4[DOI][PubMed]
  • 33. Dilli D, Aydin B, Fettah ND, Ozyazici E, Beken S, Zenciroglu A, et al. The propre-save study: effects of probiotics and prebiotics alone or combined on necrotizing enterocolitis in very low birth weight infants. J Pediatr. 2015; 166(3): 545-51[DOI][PubMed]
  • 34. Patel RM, Denning PW. Therapeutic use of prebiotics, probiotics, and postbiotics to prevent necrotizing enterocolitis: what is the current evidence? Clin Perinatol. 2013; 40(1): 11-25[DOI][PubMed]
  • 35. Manzoni P, Meyer M, Stolfi I, Rinaldi M, Cattani S, Pugni L, et al. Bovine lactoferrin supplementation for prevention of necrotizing enterocolitis in very-low-birth-weight neonates: a randomized clinical trial. Early Hum Dev. 2014; 90 Suppl 1: 60-5[DOI][PubMed]
  • 36. Ledbetter DJ, Juul SE. Erythropoietin and the incidence of necrotizing enterocolitis in infants with very low birth weight. J Pediatr Surg. 2000; 35(2): 178-81[PubMed]
  • 37. Rees CM, Pierro A, Eaton S. Neurodevelopmental outcomes of neonates with medically and surgically treated necrotizing enterocolitis. Arch Dis Child Fetal Neonatal Ed. 2007; 92(3)-8[DOI][PubMed]
  • 38. Wadhawan R, Oh W, Hintz SR, Blakely ML, Das A, Bell EF, et al. Neurodevelopmental outcomes of extremely low birth weight infants with spontaneous intestinal perforation or surgical necrotizing enterocolitis. J Perinatol. 2014; 34(1): 64-70[DOI][PubMed]
  • 39. Balanescu RN, Topor L, Dragan GC. Clinical and surgical aspects in necrotizing enterocolitis. Chirurgia (Bucur). 2013; 108(2): 184-8[PubMed]
  • 40. Duro D, Kalish LA, Johnston P, Jaksic T, McCarthy M, Martin C, et al. Risk factors for intestinal failure in infants with necrotizing enterocolitis: a Glaser Pediatric Research Network study. J Pediatr. 2010; 157(2): 203-8[DOI][PubMed]
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